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WHAT IS ROSACEA?

Rosacea is a chronic inflammatory condition resulting in facial flushing, redness, and itching. Whilst there is no cure for rosacea, many treatments can alleviate the symptoms. Rejuvenate Face can offer advice and a variety of therapies to reduce the severity and number of flare-ups.

Rosacea was previously known (misleadingly) as "acne-rosacea", but it is an entirely different disease. Some acne treatments may worsen Rosacea, so getting the diagnosis correct is vital.

How common is Rosacea?

Rosacea is a common condition affecting up to 5% of people (1 person in every 25). It affects females and males equally.

 

 Males, unfortunately, tend to get more severe symptoms.

 

The two peaks of rosacea are the late teenage years and those over 30. Rosacea can have a duration of 20 years before it settles.

Image by Myriam Zilles
Treatments for Rosacea

Unfortunately, there is no cure for Rosacea, although there are treatments that can alleviate the symptoms and, in theory, target the underlying cause.

Those suffering from Rosacea usually identify several "trigger factors" which make their Rosacea worse.

5 Skincare tips for Rosacea

Clean your face twice a day 

Moisturise

Every day

Wear

Sunscreen

Use fragrance free skin care creams

Treat your skin

Gently

Rosacea Triggers

UV exposure (sunlight)

Increasing age.


Photosensitive skin types.


Ultraviolet radiation exposure.


Smoking, alcohol.

 

Spicy foods and hot drinks.


Heat or cold temperature.


Emotional stress and exercise.


Demodex mites.

Trigger Factors for Rosacea

Diagnosing that you have Rosacea is not that straightforward. If you have a combination of Major or Minor features, you most likely have it.

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Major Features of Rosacea

Flushing/transient erythema

Papules and pustules

Telangiectasia (blood vessels)

Eye symptoms

Minor Features of Rosacea

 Skin burning

 

Skin stinging

 

Skin dryness

 

Skin swelling

The major features of Rosacea
The minor features of Rosacea
Summary of rosacea symptoms
Rosacea Treatments

Rosacea Treatments

Image by Kenzie Kraft
Topical treatments

Brimonidine

Ivermectin

Oxymetazoline

Azelaic acid

Metronidazole

Skincare for Rosacea
Image by Mark Fletcher-Brown
Oral antibiotics

Doxycycline

Oxytetracycline

Tetracycline

Erythromycin

Oral Antibiotics for Rosacea
Image by Brett Jordan
Other treatments

Chemical Peels

Laser

Botulinum Toxin ('Botox")

LED light

Ceramides

Image by Hal Gatewood
Oral drugs

Propranolol

Clonidine

Mirtazapine

Isotretinoin

Image by Matthew Tkocz
Self-care
  1. Apply moisturiser every day

  2. Avoid trigger factors

  3. Apply high-factor sunscreen (minimum SPF 30)

  4. Choose fragrance-free products

  5. Avoid flannels and sponges

  6. Use lukewarm water rather than hot

  7. Clean hands before applying cleansers

  8. Use antibacterial brushes rather than using your fingers
     

QnA Rosacea
  • Where is the tear trough?
    The tear trough is a groove between the lower eyelid at the inner corner of the eye and the upper cheek. A tear trough deformity (or hollow) is not a deformity but is used to describe the deepening of this groove. This occurs as a typical result of ageing or may be inherited. It is caused by changes in the bone, fat and skin. It is one of the first areas of the face to show signs of ageing
  • How does dermal filler work in the tear trough area?
    As explained, the tear trough is a depression in the skin, which can cause abnormal shadowing and the appearance of dark circles. Dermal fillers work by creating a lifting effect and are injected in small volumes using a needle or cannula. Most dermal fillers are supplied in 1ml syringes; however, injecting more than this in one treatment session is not recommended. If additional correction is needed, this can be performed at a later treatment session which should be discussed during your consultation.
  • Am I suitable for tear trough treatment?
    You may not be suitable for treatment if you: Are pregnant or breastfeeding. Are undergoing IVF. Suffer from keloid scarring Have active skin conditions, such as infection, acne or psoriasis Are suffering from any other infection, including COVID. Are unwell on the day of treatment. Are taking any medicines which thin the blood, such as aspirin or warfarin. Have taken Roaccutane or isotretinoin for the past 6 months. Have certain allergies Have had recent facial surgery or other dermal fillers in the same area. Have permanent implants, such as silicone implants in the face or pins and plates. Tear trough treatment may also not be suitable if: The cause of the problem is predominantly pigmentation and dark circles. If you have prominent eye bags If you are prone to puffiness under the eyes. Your skin is very lax.
  • Can any filler be used to treat the tear trough?
    No. The eye is a sensitive area to treat, and some fillers are highly unsuitable, especially if they attract water. This can make the appearance of the tear trough much worse. You should only have a specific type of hyaluronic acid filler, such as Teosyl Redensity II or Juvederm Volbella. A less water-attracting [hydrophilic ] filler should be used in the tear trough to prevent the risk of creating too much volume and unsightly bulging. One size does not fit all. Another safe alternative is to use liquid platelets or a gel made from your platelets called a bio-filler.
  • How long does tear trough deformity treatment take?
    Treatment of the tear trough area will often take between 30-60 minutes to perform. Following your procedure, the practitioner may massage the area and clean the skin. Some practitioners might apply a cream post-treatment. After the treatment, your practitioner will book a follow-up appointment. You should also receive aftercare information either in paper form or electronically before or after your treatment.
  • Is injecting the tear trough deformity painful?
    This area may be sensitive during the injection. Most dermal fillers contain a local anaesthetic which lessens the discomfort as they are injected. Usually, a topical anaesthetic, such as LMX4 or Emla™, is used to provide additional pain relief. This will be applied to the skin and left on the surface for 20-40 minutes. Also, your injector may be able to offer you a nerve block. Once the anaesthetic has worn off, there may be some expected tenderness. There should not be any significant degree of pain. If you are in much discomfort, you must contact your practitioner as this could indicate that you are developing a complication.
  • How long does tear trough filler last?
    Because the tear trough is not very mobile, it takes your body longer to dissolve the dermal filler naturally. Saying that longevity varies between products and between individuals. Most hyaluronic acid fillers will last between 6 months and 18 months.
  • What side effects should I expect after tear trough deformity correction?
    The common side effects after tear trough treatment are: Pain Minor tenderness or discomfort after your treatment is entirely normal. If you have more pain than expected, you must contact your treating practitioner immediately. Redness This is normal and usually resolves within 24 hours. If the skin becomes red and warm, this may indicate an infection. Again contact your practitioner straight away. Swelling [Oedema] Some swelling is normal after treatment and may worsen the next day. The tear trough is more prone to swelling than other facial areas. If the swelling persists, tell your practitioner. Bruising Bruising is common after tear trough injections. This can be anything from a small skin mark to extensive bruising that extends beyond the tear trough, such as a black eye. This can take up to 2 weeks to resolve. Rarely, bruising can lead to permanent staining of the skin. Infection SIgn s of infection include a warm, red, swollen area over the area that has been injected. This usually happens a few days after your treatment. If this happens, contact your practitioner for a review as soon as possible. Lumps and Bumps Lumps may be present immediately after treatment. This, to some extent, is normal. Bumps can also appear months later due to filler migrating. Lumps may appear as soft swellings or as hard nodules. If you develop a lump, ask your practitioner for a review. Extremely rare side effects are listed for completeness: Vascular Occlusion Occlusion or blockage of a blood vessel is a rare but severe complication from all dermal filler injections. A blockage results in an interruption of normal blood flow. If this is not correctly managed, the skin and tissue supplied by the blood vessel can die, resulting in scarring. It usually occurs immediately, so your injector should know immediately if this has happened. In most cases, this can be treated. Blindness This is another infrequent but devastating complication. If blindness occurs, it is likely to be permanent. Stroke Another extremely rare but documented complication of dermal fillers.
  • What should I do before my tear trough treatment?
    Ensure your practitioner is informed of any changes in your medical history or medication before receiving your injection. For one week before: Avoid sunbeds and tanning For 3 days before: Avoid taking anti-inflammatories (such as aspirin, ibuprofen, and naproxen) Avoid fish oils, St. John’s Wort, Ginkgo Biloba, garlic and Vitamin E If you are prone to bruising, taking arnica orally for a few days before treatment may lessen the risk, but this is not proven. Contact your practitioner before your appointment if: If you are unwell on the day of your appointment, contact the practitioner to reschedule. You have a social event and want to delay your treatment until after (usually, having the treatment two weeks before is sufficient to allow swelling or bruising to disappear). You cannot commit to a two-week review.
  • What is the downtime after?
    This varies depending on a few things; however, generally speaking, within 1 to 2 days, any swelling or redness should have subsided. Within a week, the signs of being injected should have entirely disappeared. Please not if you get a bruise. This can take up to two weeks to fully resolve.
  • What should I do and not do after my tear trough correction? [after-care]
    After treatment, most people can resume their normal daily activities. Some redness, tenderness and swelling at the injection sites are pretty normal. Bruising may be apparent immediately after treatment. The standard advice which is not proven is listed: Do not apply make-up for 12 hours after treatment (reduces the risk of infection). Avoid touching or rubbing the treated area. Until the swelling has settled: Avoid saunas, swimming pools and sunbeds. void extremes of hot or cold and vigorous exercise.
  • Is tear trough filler high risk?
    All treatments carry a degree of risk. All risks and complications should be discussed with you at consultation and before any treatment is agreed upon. Even though there are blood vessels in this area, the risk of a vascular injection is much lower than people or injectors think. Also, the risk of blindness is much lower even if the filler is injected into a vessel.

Useful links for Rosacea 

There are several excellent resources and information about Rosacea. These are independent, unbiased, and written by experts. NICE guidelines are referred to as Clinical Knowledge Summaries [CKS].​

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